Individual provider Active NPI

Gregory Scott Schlichter, LPCC

  • Professional Counselor
  • Northfield, MN
National Provider Identifier
1003326562
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC04094 Issued in MN
Practice address
570 Professional Dr
Northfield, MN 55057-2756
Phone
(507) 301-3412
NPI assigned
Oct 10, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC04094 MN Primary

Addresses

Primary practice location

570 Professional Dr
Northfield, MN 55057-2756

Mailing address

2005 Jefferson Rd Apt 109
Northfield, MN 55057-3195
Phone (651) 231-1616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240716001351 MN Practitioner - Mental Health Counselor 3870038763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Secure Base Counseling Center LLCGroup PAC ID 8628409299, 22 clinicians

Practice addresses (Care Compare)

570 Professional Dr
Northfield, MN 55057-2756
Phone (507) 301-3412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CC04094MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Secure Base Counseling Center LLC CurrentSince Jun 1, 2024 Accepting new patients
Turning Points Recovery Services Inc. Past Accepting new patients

Locations

570 Professional Dr
Northfield, MN 55057
Phone (507) 301-3412

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1003326562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 JEFFERSON RD APT 109",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550573195",
            "telephone_number": "651-231-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 PROFESSIONAL DR",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572756",
            "telephone_number": "507-301-3412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLICHTER",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-10",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC04094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, MN

Sources for this page

Verify at the official NPI Registry.